The present disclosure is generally related to image guided medical procedures using a surgical instrument, such as an optical scope, an optical coherence tomography (OCT) probe, a micro ultrasound transducer, an electronic sensor or stimulator, or an access port based surgery.
In the example of a port-based surgery, a surgeon or robotic surgical system may perform a surgical procedure involving tumor resection in which the residual tumor remaining after is minimized, while also minimizing the trauma to the intact white and grey matter of the brain. In such procedures, trauma may occur, for example, due to contact with the access port, stress to the brain matter, unintentional impact with surgical devices, and/or accidental resection of healthy tissue. A key to minimizing trauma is ensuring that the surgeon is aware of what is transpiring in the procedure and has an accurate depiction of the surgical site of interest on the monitor in front of him so that he understands where his tools are relative to the surgical site of interest.
FIG. 1 illustrates the insertion of an access port into a human brain, for providing access to internal brain tissue during a medical procedure. In FIG. 1, access port 12 is inserted into a human brain 10, providing access to internal brain tissue. Access port 12 may include such instruments as catheters, surgical probes, or cylindrical ports such as the NICO Brain Path. Surgical tools and instruments may then be inserted within the lumen of the access port in order to perform surgical, diagnostic or therapeutic procedures, such as resecting tumors as necessary. The present disclosure applies equally well to catheters, DBS needles, a biopsy procedure, and also to biopsies and/or catheters in other medical procedures performed on other parts of the body.
In the example of a port-based surgery, a straight or linear access port 12 is typically guided down a sulcal path of the brain. Surgical instruments would then be inserted down the access port 12. Optical tracking systems, used in the medical procedure, track the position of a part of the instrument that is within line-of-site of the optical tracking camera. Other tracking systems may be used, such as electromagnetic, optical, or mechanical based tracking systems.
Conventional systems have not offered good solutions for ensuring that a surgeon sees the surgical site of interest in enough detail. For example, when a port-based surgery is being performed, the surgeon's view down the access port is often restricted and the surgeon relies on a view of the surgical site of interest provided by a scope and shown on a display in the operating room. Conventionally, this view is a two dimensional image, which presents many limitations.
It would be desirable to have a system that helps a surgeon see the surgical site of interest and understand the 3 dimensional aspects of it. 3D depth information is beneficial for surgeons to use during surgical procedures as it improves tool manipulation within the surgical area of interest on a tissue of interest when viewing the field. In an example of endoscopic third ventriculostomy (ETV), surgeons may have a hard time to locate the basilar artery beneath the 3rd ventricle if the tissue is thick and opaque. In those cases, 3D perception provides useful visual cues to identify the location of the artery and thus avoid injuring it. As such, it would be particularly desirable to provide 3D depth information when using a single camera that also provides visualization of the field.